The king county family treatment court what is it what have we learned from our evaluation
This presentation is the property of its rightful owner.
Sponsored Links
1 / 72

The King County Family Treatment Court: What is it? What Have We Learned from our Evaluation? PowerPoint PPT Presentation


  • 39 Views
  • Uploaded on
  • Presentation posted in: General

Eric Bruns Mike Pullmann Ericka Wiggins University of Washington School of Medicine Division of Public Behavioral Health and Justice Policy www.uwhelpingfamilies.org. The King County Family Treatment Court: What is it? What Have We Learned from our Evaluation?.

Download Presentation

The King County Family Treatment Court: What is it? What Have We Learned from our Evaluation?

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


The king county family treatment court what is it what have we learned from our evaluation

Eric Bruns

Mike Pullmann

Ericka Wiggins

University of Washington School of Medicine

Division of Public Behavioral Health and Justice Policy

www.uwhelpingfamilies.org

The King County Family Treatment Court:What is it? What Have We Learned from our Evaluation?

University of WashingtonEducation Series for Child Welfare Professionals

April 11, 2012

Jill Murphy

Aubrey Glines

King County Family Treatment Court

King County Superior Court

1


Substance abuse and child welfare

Substance Abuse and Child Welfare

  • 80% of children in foster care have a parent with a substance abuse problem

    • Parents with substance problems have the lowest rate of reunification with their children

    • Their children stay in foster care over twice as long on average

  • Initiation of treatment takes an average of 4-6 months after entry to CW system


The need for a solution

The need for a solution

  • Treatment completion is associated with:

    • Less time in foster care

    • Reunification rates

  • More rapid treatment entry and longer treatment duration is associated with:

    • Treatment completion

    • Treatment success

    • Less time in foster care

    • Reunification rates


Drug courts

Drug Courts

  • Interdisciplinary, coordinated, team-based approach to avoiding future involvement in (criminal) justice system

  • As of 2010: 2,459 drug courts in U.S.

    • Number increased by 50% from 2004 – 2010

  • Seven meta-analyses

    • Rigor of studies often lacking; however, positive effects found

      • Positive treatment outcomes

      • Reduced re-arrest


Family treatment drug courts

Family Treatment Drug Courts

  • Apply drug court approach to cases of child abuse and neglect

  • Goal = enhance possibility of family reunification within legal timeframes by:

    • Facilitating entry and completion of treatment

    • Supporting parent to remain abstinent

    • Improving child safety/family functioning

  • As of 2009, NADCP reports 322 FTDCs

    • 13% of all drug courts in U.S.

    • Increase of 66% from 2005


Today s presentation

Today’s presentation

  • The King County Family Treatment Court

    • Goals

    • Population of focus

    • Program description

    • Case flow process

  • What we have learned from an evaluation

    • Process evaluation

    • Outcome evaluation


The king county family treatment court

The King County Family Treatment Court

Jill Murphy

KCFTC Program Supervisor

Aubrey Glines

KCFTC Graduate


Kctv video

KCTV Video

  • http://youtu.be/XU1gSDyTBxw


King county ftc primary goals

King County FTC Primary Goals

Children have safe and permanent homes within permanency planning guidelines;

Families of color have outcomes from dependency cases similar to families not of color;

Parents are better able to care for themselves and their children and seek resources to do so; and

The cost to society of dependency cases involving substances is reduced.

9


The king county family treatment court what is it what have we learned from our evaluation

The King County Family Treatment Court

  • KCFTC PROCESSES AND FUNCTIONS

  • Comprehensive SB Assessment

  • High quality, appropriate CD Services

  • Timely/effective MH and other services

  • Effective care planning and management

  • Expanded and more frequent visitation

  • Consistent, timely incentives & sanctions

  • Random UA Screens

  • Effective pre-hearing case conferences

  • Effective judicial interaction

  • SHORT-TERM OUTCOMES

  • Eligibility/enrollment completed quickly

  • Enrollment in appropriate CD services

  • Parents compliant with/complete treatment

  • Parents ultimately able to remain sober

  • Parents/children more fully engaged in svcs

  • Parents/children receive needed services

  • Decreased placement disruptions

  • Parents compliant with court orders

  • Less negative effect on child well-being

  • Less disruption of child-parent bonds

  • Increased family reunification rates

  • Earlier determination. of alternate placement options

  • NATIONAL BEST PRACTICES

  • Communication bw Court and providers

  • Judge plays active role in Tx process

  • Judge responds to positive & noncompliant beh.

  • Mechanisms for shared decision making

  • Accountability for Tx services

  • Strategy for responding to noncompliance

  • MIS allow data to be assembled/reviewed

  • Enhancement of due process

  • Team members provided adeq resources

10


Population focus

Population Focus

Up to 60 children at a time, whose parent(s):

  • Admit to the court that his/her child is dependent or have an existing dependency finding

  • Are chemically dependent and willing to go to treatment;

  • Are at least 18 years of age;

  • Sign a Consent to Release Confidential Information Form so that the team may share information with other team members and outside community providers;

  • Have no felony child abuse or sexual abuse guilty findings; and

  • Applications/referrals to FTC must be received no later than six months from the date of dependency petition.


Kcftc program model

KCFTC Program Model

  • Parents agree to enter a more intensive court process

    • Expectation = 12 mos – 2 years duration

  • Case management to ensure connection to appropriate chemical dependency treatment

  • Cross-disciplinary pre-hearing staffings to present a unified approach at hearings

  • Case review hearings every other week until frequency can be stepped down

  • Treatment Liaison who monitors parent’s progress in CD and MH treatment and provides case management

  • Formal Wraparound Process for approx 1/3 of families (15 at a time)

  • Social Workers dedicated to the FTC with reduced caseloads (12:1)


Kcftc team members

Judge

Assistant Attorney General

Parent’s Defense Attorney

Child’s Attorney

Treatment specialist/ Treatment liaison

Treatment provider

Court Appointed Special Advocate (CASA)

Wraparound coordinator

DCFS Social Workers

FTC Program Supervisor

FTC Program Court Specialist

Family members/friends

Family support providers

KCFTC Team Members


The king county family treatment court what is it what have we learned from our evaluation

Petition

Exit System

Dismissed

Petition

Petition

Petition

Petition

Petition

Dismissed

Dismissed

Dismissed

Dismissed

Dismissed

Enter FTC*

(See separate flow chart)

Shelter Care

30

-

Day Shelter

Pre

-

Trial

Fact

-

Finding

Disposition

Shelter Care Hearing

Placement in

Dependency

Case Conf

.

Care Review

Conference

Hearing

Petition

Hearing

(

w

/

in

72

hours of place

-

Shelter Care

Petition Filed

Approved

(

w

/

in

30

days of

ment or filing

,

whichever

(

30

days prior to

(

21

days prior to

(

w

/

in

75

days

(

same day as or w

/

in

14

occurs first

)

placement

)

fact

-

finding

)

of filing

)

days of dep finding

)

fact

-

finding

)

Dependency Stipulated

Dept

.

Review Hearing

Child

supervision

(

the sooner of

90

days

returned

continues for

from Dispo

.

or

6

mos

.

Exit FTC w/o Permanency Goal Achieved

home

from date of placement

)

6

mos

.

Dependency

Continued

Review

*There can be entry into FTC anytime after dependency is established as long as a referral is made to FTC within 6 months of the filed petition date.

Permanency

Hearing

Planning Hearing

(

12

months from date of

placement

&

every

12

months thereafter

)

Permanency

Yes

Goal Achieved

?

No

Petition for

Yes

Parental Rights

Termination

?

No

Review Hearing

(

w

/

in

6

months after

permanency planning

hearing

)

Petition for

Petition for

Termination of

Permanency

Yes

Parental Rights

No

Yes

Parental Rights

Goal Achieved

?

Termination

?

Filed

Original Chart prepared by Michael Curtis on January 12, 2006

No

Juvenile Dependency Case Flow (noting FTC)

14


The king county family treatment court what is it what have we learned from our evaluation

Other FTC Hearings:

Check In Hearing: Set for following week after positive/missed UA or noncompliance w/ tx

Compliance Clock Hearing: Can be applied after 5th response and set 60 days out from current hearing

Motion Hearing: Can be set anytime there is a contested issue. Not heard duringregular FTC calendar

Box Color Legend:

Red: Not a hearing

Green: Beginning and end of FTC Process

Blue: FTC Review Hearings

Graduated Blue: Does not occur on every case

Orange: Not unique to FTC

Purple: Unique to FTC and can occur throughout FTC process

Discharge/Opt Out Hearing: Dependency dismissed or discharged to regulardependency

FAMILY TREATMENT COURT CASE PROCESSING FLOW CHART

15


Evaluation of the king county family treatment court

Evaluation of the King County Family Treatment Court

Division of Public Behavioral Health and Justice Policy

University of Washington School of Medicine

UWHelpingFamilies.org


Needs for the evaluation

Needs for the Evaluation

  • Provide information needed by the KCFTC and its stakeholders

  • Expand the research base on FTDCs

    • Do FTDCs achieve their stated goals and outcomes?

    • Do they contribute positively to federal priorities for CW systems?

    • Do common criticisms of drug courts apply to FTDCs?

      • Widening the net of involvement in justice system

      • Mandate longer involvement in justice system

      • Limit access to or completion of treatments

      • Not cost effective


Summary of the ftdc literature

Summary of the FTDC Literature

Four studies of FTC model (Boles et al., 2007; Edwards et al., 2005; Green et al., 2007, 2009; Worcel et al., 2008;)

All four studies show positive outcomes:

Parents enrolled in treatment more quickly

Parents received treatment services for a longer mean duration

Parents were more likely to successfully complete treatment

Children placed in permanent living situations more quickly

Children more likely to be reunified (e.g., 42% vs. 27% at 2 years; 70% vs. 45% at 3-4 years)

No study found between-group differences in future abuse/neglect reports


Summary of the ftdc literature1

Summary of the FTDC Literature

NPC Research, the most active evaluators of FTCs and drug treatment courts, has completed several cost-benefit analyses at sites across the nation. The table below summarizes their findings:


Components of the kcftc evaluation

Components of the KCFTC Evaluation

Process evaluation

Interviews with team members and stakeholders, 2006 and 2008

Parent interviews, 2007-2009

Outcomes evaluation

Analysis of child placement data from Children’s Administration and adult treatment data from the Division of Behavioral Health and Recovery

Cost-benefit analysis

Currently underway

22


Respondents

Respondents

2006 (n=39)

2008 (n=37)


The king county family treatment court what is it what have we learned from our evaluation

2006: Mean= 3.4 Std. Dev= .793

2008: Mean= 3.73 Std. Dev= .693


The king county family treatment court what is it what have we learned from our evaluation

2006: Mean= 5 Std. Dev= 1.4

2008: Mean= 5.47 Std. Dev= 1.36


Summary of major questions means

Summary of Major QuestionsMeans


Summary of process and function questions means

Summary of Process and Function QuestionsMeans

A little bit

successful

Somewhat

Successful

Moderately

successful

Extremely

successful


What we learned from process evaluation

What we learned from process evaluation

Strengths

Strong opinions about the positive impact of KCFTC

Most processes and functions viewed as successfully being accomplished by 2008

Relative Weaknesses

Respondents less confident that goal of serving a representative population was being met

Respondents believed client load was less than optimal (serving too few families)

Mixed opinions on the amount of shared vision among team members

Certain processes and functions:

Efficiency of eligibility determination and intake

Consistency and effectiveness of incentives and sanctions

Resources and training for KCFTC staff and team members

28


Outcome evaluation research question 1

Outcome Evaluation:Research Question 1

  • When compared to comparable non-FTDC participants, do FTDC participants differ in terms of their experience with the court and treatment system?

  • Hypotheses – FTDC participants would:

    • Have more court hearings;

    • Enter treatment more often;

    • Enter treatment more quickly;

    • Attend treatment sessions more consistently;

    • Receive more treatment events;

    • Receive a broader treatment array;

    • Remain in treatment longer; and

    • Successfully discharge from treatment more often.


Research question 2

Research Question 2

  • When compared to children of non-FTDC participants, do children of FTDC participants demonstrate more positive child welfare outcomes?

  • Hypotheses – KCFTC children would:

    • Spend less time in out-of-home placements;

    • Reunify with their parents more often;

    • Get placed in permanent living situations more quickly; and

    • Have fewer subsequent child welfare investigations and founded investigations


Research question 3

Research Question 3

  • Do families of color have outcomes similar to families not of color?

    • Treatment outcomes

    • Child welfare outcomes


Outcome evaluation

Outcome Evaluation

  • Administrative data:

    • Treatment data from Division of Behavioral Health and Recovery

    • Child welfare data from Children’s Administration

    • Hearing data from King County Superior Court

    • Data collected September 2010

  • Family Treatment Court group:

    • Selected all parents admitted to the FTC between March 2006 and October 2009

  • Comparison group:

    • Eligible parents referred but not admitted to the Family Treatment Court

    • Randomly selected a reasonable number

    • Statistically matched (propensity score methods) on caregiver age and race, number of prior child welfare investigations, whether parent was in treatment at petition, number of prior treatment episodes, and primary drug of choice


Reasons why parent is in comparison group

Reasons why parent is in comparison group


The king county family treatment court what is it what have we learned from our evaluation

Detail: specific race/ethnicity

Parent demographics

  • Mean # of children per participant

  • Comparison=1.39

  • KCFTC = 1.46

  • Parent mean age

  • Comparison = 31

  • KCFTC = 31

  • Total # of parents = 268

  • Comparison = 182

  • KCFTC = 76

Note: no significant differences


Prior investigations

Prior Investigations

Note: No statistically significant differences


The king county family treatment court what is it what have we learned from our evaluation

Child demographics

  • Child Mean Age

  • Comparison = 4.2

  • KCFTC = 3.5

  • Number of children

  • Comparison = 235

  • KCFTC = 89

Note: Statistically significant difference for Native American


Status of ftc parent at time of data collection

Status of FTC parent at time of data collection

37


Note on analytic approach

Note on Analytic Approach…

  • 1). “Intent to treat”

    • All parents who were admitted to FTC were included in all analyses, even if they opted out or had an unsuccessful outcome.

      • No parent who was ever in FTC was ever included in the comparison group

  • 2). Index Petition Date

    • “Time Zero” or comparable start point for both groups was the petition date, not date of entry into FTC (comparison group had no date of entry)

These decisions likely result in more conservative findings


The king county family treatment court what is it what have we learned from our evaluation

  • Question 1: Do FTC participants have different treatment and court experiences than comparable non-FTC parents?

    • Do they experience more court hearings?

    • Are they more likely to enter treatment?

    • Do they enter treatment more quickly?

    • Are they more likely to attend treatment?

    • Do they remain in treatment longer?

    • Are they more likely to be successfully discharged from treatment?


Ftc parents have more court hearings

FTC parents have more court hearings

  • 11 months post petition (mean follow up time for overall sample):

    • FTC: mean 16.1 (SD = 4.8) hearings

    • Comp: 5.9 (2.4)

      • (p<.001)

    • Review hearings were 4.5 times more frequent for FTC (accounted for 75% of all FTC hearings)


Ftc parents are more likely to enter treatment

FTC parents are more likely to enter treatment

FTC parents were 63% more likely to be admitted to treatment.

Note: All differences statistically significant


Ftc parents enter treatment three times as fast

FTC parents enter treatment three times as fast

  • Of those parents entering treatment who were not already in treatment at the index petition, the median days until treatment entry were:

  • Comparison: 120

  • KCFTC: 36

Proportion not admitted

Note: Statistically significant difference, p < .001


Ftc parents received broader service array

FTC parents received broader service array

Of those admitted to any treatment

* Statistically significant difference, p < .05


Ftc parents received broader service array1

FTC parents received broader service array

Of those who received any treatment

* Statistically significant difference, p < .05


Ftc parents received more treatment but were not significantly more likely to attend treatment

FTC parents received more treatment but were not significantly more likely to attend treatment

  • Avg. # of treatment events per person who received treatment:

  • KCFTC = 116 (SD=97)

  • Comparison = 51 (SD=57)

Note: Statistically significant difference, p < .05

Note: Not statistically significant difference, p =.40


Ftc parents remain in treatment longer of those entering treatment n 110

FTC parents remain in treatment longer (Of those entering treatment; N=110)

  • Of those parents who entered treatment, the median days in treatment were:

  • Comparison: 44

  • FTC: 109

Note: Statistically significant difference at beginning and middle, p < .05


Success in treatment

Success in treatment

  • FTC parents remained in treatment twice as long (median of 109 days compared to 44)

  • FTC parents 37% more likely to be successfully discharged from treatment (72% compared to 54%)

Note: Statistically significant differences, p < .05


The king county family treatment court what is it what have we learned from our evaluation

  • Question 2: Do FTC families, compared to similar families who did not receive FTC services, have more positive child welfare outcomes? Specifically:

    • Do the children of FTC participants spend less time in out of home placement?

    • Are the children of FTC participants placed in permanent living situations more quickly overall?

    • Are FTC children more likely to have a permanent placement?

    • Are FTC participants less likely to have subsequent CPS investigations?


Ftc children spend less time in out of home placements

FTC children spend less time in out-of-home placements

  • Median days in out of home placement:

  • Comparison: 689

  • FTC: 476

Note: Statistically significant difference, p < .05


Ftc children end involvement with the child welfare system more quickly

FTC children end involvement with the child welfare system more quickly

  • Median days until permanent placement:

  • Comparison: 813

  • FTC: 718

Note: Statistically significant difference, p < .05


Child welfare outcomes at end of study window

Child Welfare OutcomesAt end of study window

  • FTC children spent 30% less time in out-of-home placements

    • median of 476 days, compared to 689

  • FTC children spent 20% less time in the child welfare system

    • median of 718 days, compared to 813

  • FTC children 43% more likely to have a permanent placement

    • 61% compared to 43%

Note: Statistically significant differences, p < .05


Placement types reunification at end of study window

Placement types/ReunificationAt end of study window

  • FTC children 2.5 times more likely to return to the custody of their parent (27% compared to 11%)

  • FTC children half as likely to be in an out of home placement (24% compared to 46%)

  • FTC children 1.9 times more likely to be returned home (in parental custody, reunified, trial home visit; 55% compared to 29%)

Note: Statistically significant differences, p < .05


Subsequent child welfare investigations all parents at end of study window

Subsequent child welfare investigations: All parentsAt end of study window

Note: Not statistically significant difference


The king county family treatment court what is it what have we learned from our evaluation

Subsequent child welfare investigations: Only parents with child returned home

At end of study window

p=.09

p=.13


Subsequent child welfare investigations all children at end of study window

Subsequent child welfare investigations: All childrenAt end of study window

Note: Not statistically significant difference


The king county family treatment court what is it what have we learned from our evaluation

Subsequent child welfare investigations: Only children who returned home

At end of study window

Subsequent removals: 3% for FTC group (n=1) vs. 13% for Comparison (n=3); p=.13


Findings similar to other ftdc studies

Findings similar to other FTDC studies


Question 3 do families of color have outcomes similar to families not of color

Question 3: Do families of color have outcomes similar to families not of color?


Question 3 do families of color have outcomes similar to families not of color1

Question 3: Do families of color have outcomes similar to families not of color?


Admitted to treatment through dbhr after petition all parents

Admitted to treatment through DBHR after petitionAll parents

Parent of color

Parent white

Parent of color

Parent white

  • Parents of color did not differ from white parents in their likelihood to:

  • Be in treatment when petition was filed

  • Be admitted to treatment after petition

  • Schedule treatment episode after petition is filed

Note: No statistically significant differences

60


Median days until treatment entry of those not in treatment at petition

Median days until treatment entryOf those not in treatment at petition

Parent white

Parent of color

Parent white

Parent of color

Note: White-white, p < .05

POC-POC, p < .10

61


Median days in first treatment

Median days in first treatment

Parent white

Parent white

Parent of color

Note: White-white, p < .05

POC-POC, p < .10

FTC: POC-White mixed

Parent of color

62


Length of time in first treatment episode

Length of time in first treatment episode

  • Of those parents entering treatment, the median days in first treatment episode:

  • Comparison, parent of color: 43

  • Comparison, white: 53

  • KCFTC, parent of color: 77

  • KCFTC, white: 151

Note: No statistically significant differences

63


The king county family treatment court what is it what have we learned from our evaluation

Percentage successfully completing a treatment episodeOf those receiving treatment

Parent of color

Parent white

Parent of color

Parent white

Note: POC-POC p < .05

No other significant differences

64


Percentage of children with permanent placements

Percentage of children with permanent placements

Child white

Child of color

Child white

Child of color

Note:

All: Comp-FTC p < .05

No other significant differences

65


Percentage of children remaining in out of home placement

Percentage of children remaining in out of home placement

Child white

Child of color

Note:

All: Comp-FTC p < .05

FTC: COC – Child white, p < .10

No other significant differences

Child white

Child of color

66


Comparing ftc to regular court for families of color

Comparing FTC to regular court for families of color

  • Generally indicate that families of color in FTC had more positive outcomes than families of color in the comparison group

    • 61% more likely to enter treatment

    • Enter treatment 63% faster

    • Remain in treatment nearly twice as long

    • 49% more likely to complete treatment

    • Children 39% more likely to be permanently placed

    • Children 54% more likely to be returned home


Comparisons by race in ftc

Comparisons by race in FTC

  • Parents of color in the FTC were not significantly different than white parents on:

    • Percentage admitted to treatment

    • Speed of admission to treatment

    • Percentage successfully completing treatment

  • Parents of color spent less time than white parents in treatment

  • Children of color might be more likely to remain in out-of-home placements (borderline significance)


Outcome study summary

Outcome Study Summary

  • The King County Family Treatment Court is one of a variety of problem-solving courts

  • Staff from several disciplines and agencies collaborate on supervision and support

  • Stakeholders generally have positive opinions about the development and functioning of the court

  • Parents have more successful substance use treatment outcomes

  • Children are more likely to exit the child welfare system and be returned to the care of their parents

  • Other research with similar findings to our research also found significant long-term cost savings


The king county family treatment court what is it what have we learned from our evaluation

Internal vs. External costs and benefits

Overall costs/benefits to society

County government

State government

Federal government

Participants

Citizens and communities

Family Treatment Court

Child Welfare

DSHS (treatment)

  • External benefits  underproduction of the service (i.e. too little Family Treatment Court)

  • External costs  overproduction of the service


The king county family treatment court what is it what have we learned from our evaluation

Justice System

Dependency court hearings

Adult contacts with law: prison, jail, criminal hearings, probation, etc.

Child contacts with law: prison, jail, criminal hearings, probation, etc.

Damages to victims

Others

Employment

Education

Physical health care

Public assistance

Child Welfare

Placements

Caseworker time

Caregiver-child visitations

Costs and Benefits

Substance Use and Mental Health treatment

DSHS-provided treatment services

Private pay or insurance treatment services

Non-monetary costs

Emotional pain from loss of child/parent

Broken communities

Emotional pain to victims

71


The king county family treatment court what is it what have we learned from our evaluation

Please contact us with any questions

Eric Bruns

ebruns.@uw.edu

Mike Pullmann

[email protected]

Mark Wirschem

[email protected]

Jill Murphy

[email protected]


  • Login